Members of Gov. Nikki Haley's new prescription drug abuse task force acknowledge that other nearby states, including Georgia, Florida and Kentucky, have been tackling painkiller addiction more aggressively than South Carolina has done.
"Once (other states) started tightening their strategy, at least theoretically, we felt like we would be prone to victimization by these doctors who may be looking for the path of least resistance," said Dr. Louis Costa, president of the South Carolina Board of Medical Examiners and a member of Haley's new South Carolina Prescription Drug Abuse Prevention Council.
Doctors who over-prescribe painkillers - intentionally or naively - play a large role in the state's prescription drug abuse problem, Costa acknowledged.
"There's a symbiotic relationship between the unscrupulous physicians and the drug seekers," he said. But, "If we limit the number of prescribed drugs, we'll make a significant impact right off."
Most prescription drug abusers don't have valid doctors' orders for painkillers. They steal medicine from friends and family members or buy high-priced pills on the black market.
But when federal researchers focused specifically on men and women who overdose on these drugs, the medicine was most likely purchased with a legitimate prescription written for that patient by a doctor, a new Centers for Disease Control and Prevention study shows.
"Many abusers of opioid pain relievers are going directly to doctors for their drugs," said CDC Director Tom Frieden, in a recent statement about the report.
The same is true in South Carolina. Haley announced last week that her office organized the Prescription Drug Abuse Prevention Council to combat the problem in this state. While South Carolina ranks 23rd highest in the country for per capita overdose deaths and 10th highest in the country for the number of painkiller prescriptions per capita, a 2013 report by the South Carolina Office of the Inspector General called current efforts here only "reactionary and fragmented."
"No state agency has a proactive posture on addressing pill mills or high prescribing, naive physicians," the Inspector General's report said.
On Monday, Jim Beasley, spokesman for the S.C. Department of Health and Environmental Control, could not provide the number of South Carolina physicians who have been flagged in the past five years for over-prescribing painkillers. DHEC's Bureau of Drug Control has law enforcement authority to regulate controlled substances and to identify potentially improper dispensing.
The department's website indicates the bureau receives "750 to 1,000 complaints each year involving diversion of controlled substances from legal outlets." Up to 500 of those each year result in prosecution and 25 percent those prosecuted are health care professionals.
S.C. Medicaid Director Tony Keck said his agency is now monitoring about 30 or 40 physicians in South Carolina who may be over-prescribing painkillers.
"These are just Medicaid doctors," Keck said. Others are likely slipping through the cracks, he said, because many physicians who knowingly over-prescribe painkillers realize that Medicaid tracks their patterns and they only accept cash for their services.
"Other states have been dealing with this problem in a much more urgent way," said Keck, another member of the governor's new council. "Everybody recognized that we could be doing a better job at it."
While DHEC established an electronic system years ago that allows doctors to find out how many prescriptions their patients have been given by other doctors in the past, only 22 percent of providers in the state have signed up to use the database. Even fewer actually use it.
"It has very poor participation by all standards," said Costa. He said the state may soon require doctors to use it.
Another problem, he said, is that Board of Medical Examiners doesn't have access to any of the information DHEC tracks. It means the board, which regulates medical licenses in South Carolina and also oversees disciplinary action against health care providers, does not know who or how many physicians are over-prescribing addictive painkillers.
That will change soon, too, Costa said.
"What DHEC will now be able to do is actually look at those individuals and forward their identity to us," he said. "We did not have the wherewithal to do that prior to this new initiative."
Reach Lauren Sausser at 937-5598.
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